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The organization also warns that since its not approved for human clinical use by any global regulatory authority, it may lead to negative health effects including immunogenic reactions (antibodies), peptide impurities, and limited safety data for proposed routes of use
[13] Depression: One 2014 review assessed the use of ALCAR in fourteen clinical trials for various conditions with depressive symptoms
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Thats why B12 injections are often given as treatment
This applies to topical treatments such as niacinamide
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